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Perceptions of Severe Asthma and Asthma-COPD Overlap Syndrome Among Specialists: A Questionnaire Survey

 Sang Heon Kim  ;  Ji Yong Moon  ;  Jae Hyun Lee  ;  Ga Young Ban  ;  Sujeong Kim  ;  Mi Ae Kim  ;  Joo Hee Kim  ;  Min Hye Kim  ;  Chan Sun Park  ;  So Young Park  ;  Hyouk Soo Kwon  ;  Jae Woo Kwon  ;  Jae Woo Jung  ;  Hye Ryun Kang  ;  Jong Sook Park  ;  Tae Bum Kim  ;  Heung Woo Park  ;  You Sook Cho  ;  Kwang Ha Yoo  ;  Yeon Mok Oh  ;  Byung Jae Lee  ;  An Soo Jang  ;  Sang Heon Cho  ;  Hae Sim Park  ;  Choon Sik Park  ;  Ho Joo Yoon  ;  Severe Asthma Work Group, the Korean Academy of Asthma, Allergy and Clinical Immunology 
 ALLERGY ASTHMA & IMMUNOLOGY RESEARCH, Vol.10(3) : 225-235, 2018-05 
Journal Title
Issue Date
Severe asthma ; asthma-chronic obstructive pulmonary disease overlap syndrome ; perception
Purpose: Severe asthma and asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) are difficult to control and are often associated with poor clinical outcomes. However, much is not understood regarding the diagnosis and treatment of severe asthma and ACOS. To evaluate the current perceptions of severe asthma and COPD among asthma and COPD specialists, we designed an e-mail and internet-based questionnaire survey. Methods: Subjects were selected based on clinical specialty from among the members of the Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Academy of Tuberculosis and Respiratory Diseases. Of 432 subjects who received an e-mail invitation to the survey, 95 subjects, including 58 allergists and 37 pulmonologists, responded and submitted their answers online. Results: The specialists estimated that the percentage of severe cases among total asthma patients in their practice was 13.9%±11.0%. Asthma aggravation by stepping down treatment was the most common subtype, followed by frequent exacerbation, uncontrolled asthma despite higher treatment steps, and serious exacerbation. ACOS was estimated to account for 20.7% of asthma, 38.0% of severe asthma, and 30.1% of COPD cases. A history of smoking, persistently low forced expiratory volume in 1 second (FEV1), and low FEV1 variation were most frequently classified as the major criteria for the diagnosis of ACOS among asthma patients. Among COPD patients, the highly selected major criteria for ACOS were high FEV1 variation, positive bronchodilator response, a personal history of allergies and positive airway hyperresponsiveness. Allergists and pulmonologists showed different assessments and opinions on asthma phenotyping, percentage, and diagnostic criteria for ACOS. Conclusions: Specialists had diverse perceptions and clinical practices regarding severe asthma and ACOS patients. This heterogeneity must be considered in future studies and strategy development for severe asthma and ACOS.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
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